[Federal Register Volume 63, Number 130 (Wednesday, July 8, 1998)]
[Notices]
[Pages 36915-36920]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-18017]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
[Announcement Number 99005]


Applied Research Program in Emerging Infections Correlation of 
Environmental Monitoring of Microbial Agents With Disease Control; 
Notice of Availability of Funds for Fiscal Year 1999

Introduction

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 1999 funds for competitive grants and/
or cooperative agreements to support applied research on emerging 
infections. This announcement specifically addresses the correlation of 
environmental monitoring of microbial agents with disease control.
    CDC is committed to achieving the health promotion and disease 
prevention objectives of Healthy People 2000, a national activity to 
reduce morbidity and mortality and improve the quality of life. This 
announcement is related to the priority area of Immunization and 
Infectious Diseases. (For ordering a copy of Healthy People 2000, see 
the section Where to Obtain Additional Information.)

Authority

    This program is authorized under Sections 301(a) and 317(k)(2) of 
the Public Health Service Act, as amended [42 U.S.C. 241(a) and 
247b(k)(2)].

Smoke-Free Workplace

    CDC strongly encourages all grant recipients to provide a smoke-
free workplace and to promote the non-use of all tobacco products, and 
Public Law 103-227, the Pro-Children's Act of 1994, prohibits smoking 
in certain facilities that receive Federal funds in which education, 
library, day-care, health-care and early childhood development services 
are provided to children.

Eligible Applicants

    Applications may be submitted by public and private nonprofit 
organizations and governments and their agencies. Thus, universities, 
colleges, research institutions, hospitals, other public and private 
nonprofit organizations, including State and local governments or their 
bona fide agents are eligible to apply.

    Note: An organization described in Section 501(c)(4) of the 
Internal Revenue Code of 1986 which engages in lobbying activities 
shall not be eligible to receive Federal funds constituting an 
award, grant, contract, loan, or any other form.

    Only one application will be accepted from any single applicant, 
organization, government, or agency.

Availability of Funds

    Approximately $500,000 is available in FY 1999 to fund one to three 
awards, ranging from $100,000 to $500,000. It is expected the award(s) 
will begin on or about March 1, 1999, and will be made for a 12-month 
budget period within a project period of up to three years. (The 
funding amounts listed above are for the first 12-month budget period 
and include both direct and indirect costs.) Funding estimates may vary 
and are subject to change.
    Continuation awards within an approved project period will be made 
on the basis of satisfactory progress and availability of funds.

[[Page 36916]]

Determination of Which Instrument to Use

    Applicants must specify the type of award for which they are 
applying, either grant or cooperative agreement. CDC will review the 
applications in accordance with the evaluation criteria. Before issuing 
awards, CDC will determine whether a grant or cooperative agreement is 
the appropriate instrument based upon the need for substantial CDC 
involvement in the project.
    To assist applicants in making a determination as to which type of 
award to apply for, the following information is provided:
1. Grants
    A research project grant is one in which substantial programmatic 
involvement by CDC is not anticipated by the recipient during the 
project period. Applicants for grants must demonstrate an ability to 
conduct the proposed research with minimal assistance, other than 
financial support, from CDC. This would include possessing sufficient 
resources for clinical, laboratory, and data management services and a 
level of scientific expertise to achieve the objectives described in 
their research proposal without substantial technical assistance from 
CDC.
2. Cooperative Agreements
    A research project cooperative agreement is one in which CDC will 
assist recipients in conducting the proposed research. The application 
should be presented in a manner that demonstrates the applicant's 
ability to address the research problem in a collaborative manner with 
CDC.

Use of Funds

Restrictions on Lobbying

    Applicants should be aware of restrictions on the use of HHS funds 
for lobbying of Federal or State legislative bodies. Under the 
provisions of 31 U.S.C. Section 1352 (which has been in effect since 
December 23, 1989), recipients (and their subtier contractors) are 
prohibited from using appropriated Federal funds (other than profits 
from a Federal contract) for lobbying Congress or any Federal agency in 
connection with the award of a particular contract, grant; cooperative 
agreement, or loan. This includes grants/cooperative agreements that, 
in whole or in part, involve conferences for which Federal funds cannot 
be used directly or indirectly to encourage participants to lobby or to 
instruct participants on how to lobby.
    In addition, the FY 1998 ``Department of Labor, Health and Human 
Services, and Education, and Related Agencies Appropriations Act'' 
(Public Law 105-78) states in Section 503 (a) and (b) that no part of 
any appropriation contained in this Act shall be used, other than for 
normal and recognized executive-legislative relations, for publicity or 
propaganda purposes, for the preparation, distribution, or use of any 
kit, pamphlet, booklet, publication, radio, television, or video 
presentation designed to support or defeat legislation pending before 
the Congress or any State legislature, except in presentation to the 
Congress or any State legislature itself. No part of any appropriation 
contained in this Act shall be used to pay the salary or expenses of 
any grant or contract recipient, or agent acting for such recipient, 
related to any activity designed to influence legislation or 
appropriations pending before the Congress or any State legislature.

Background

    Once expected to be eliminated as a public health problem, 
infectious diseases remain the leading cause of death worldwide. In the 
United States (U.S.) and elsewhere, infectious diseases increasingly 
threaten public health and contribute significantly to the escalating 
costs of health care.
    In 1992, the Institute of Medicine of the National Academy of 
Sciences published a report entitled Emerging Infections, Microbial 
Threats to Health in the United States highlighting the threat of 
emerging infections and making specific recommendations to address the 
threat. This report emphasized a critical leadership role for CDC in a 
national effort to detect and control infectious disease threats.
    In partnership with other Federal agencies, State and local health 
departments, academic institutions, and others, CDC has developed a 
plan for revitalizing the nation's ability to identify, contain, and 
prevent illness from emerging infectious diseases. The plan, Addressing 
Emerging Infectious Disease Threats; A Prevention Strategy for the 
United States, includes applied research as a major objective, 
stressing the importance of integrating laboratory science and 
epidemiology to optimize public health practice in the U.S. CDC has 
developed an Extramural Applied Research Program in Emerging Infections 
(EARP) designed to fill gaps in existing support for research in 
emerging infectious disease surveillance, epidemiology, and prevention. 
This announcement specifically addresses the correlation of 
environmental monitoring of microbial agents with disease control.
    The microorganisms present in the environment have played a role in 
the transmission of infectious diseases. Legionella, Cryptosporidia, 
Cyclospora, Aspergillus, and vancomycin-resistant enterococci are just 
a few examples of agents with public health significance. There are 
very few situations where the results of environmental monitoring have 
been correlated with disease control. A good example of a situation 
where correlation has been done is the microbial quality of water and 
dialysate in hemodialysis units. Here it has long been established that 
once bacteria (and in some instances endotoxin) go above certain 
concentrations (2,000 CFU/ml in dialysate, 200 CFU/ml in water, or 5 
EU/ml in water used to reprocess hemodialyzers) the risk of patients 
developing bacteremia or a ``pyrogenic'' reaction during dialysis 
increases substantially. However, the correlation of environmental 
monitoring of microbial agents with disease control in other situations 
is unclear.
    Legionnaires' disease (LD) occurs when an aerosol of water 
containing Legionella spp. is inhaled. There are 8,000-18,000 cases of 
LD that occur each year in the U.S., and 23 percent of case-patients 
reported to the CDC appear to have acquired the infection in a health-
care facility. Recent investigations have demonstrated that nosocomial 
transmission from colonized hot water systems can occur for years or 
even decades unless the illness is recognized and the organism is 
eradicated. Case-fatality rates among patients with nosocomial LD may 
reach > 30 percent, particularly in immunocompromised individuals. In 
1997, a survey of 253 National Nosocomial Infections Surveillance 
System (NNIS) hospitals indicated that 31 percent have identified cases 
of nosocomial LD since 1990 and in 41 percent of hospitals legionellae 
were recovered from the potable water systems. However, many hospitals 
with cases had done little to reduce colonization and prevent further 
transmission. Current CDC guidelines only state that an environmental 
investigation and intervention should be done after nosocomial cases 
are identified.
    Vancomycin-resistant enterococci (VRE) were first reported in 1989 
and have increased rapidly in incidence and prevalence in the interim. 
At 189 hospitals reporting to the NNIS system, the percentage of 
enterococcal isolates from all body sites that were resistant to 
vancomycin increased from 0.3 percent in 1989 to 10.5 percent in 1995.

[[Page 36917]]

Numerous hospital VRE outbreaks have been reported and contamination of 
environmental surfaces (e.g., bed rails, countertops) with VRE has been 
documented. Since VRE may survive routine cleaning and disinfection 
procedures, contamination of environmental surfaces may contribute to 
nosocomial transmission of VRE. There is a need to document the extent 
of environmental contamination with this organism, the extent to which 
such contamination contributes to nosocomial transmission, and the 
cleaning/disinfection procedures necessary to remove VRE.
    Invasive aspergillosis is a threat to patients with compromised 
macrophage or neutrophil function (i.e., patients with neutropenia, 
receiving high-dose corticosteroid therapy) or with underlying chronic 
lung disease. Aspergillus spp., are ubiquitous and are routinely 
isolated from tap water, soil, decaying vegetation, wet paint, food, 
dust, and even sanitizing agents used in hospitals. Several outbreaks 
of aspergillosis have occurred during periods of construction in and 
around hospitals. Current recommendations are directed at controlling 
the production of aerosols during these periods. Additionally, there is 
evidence that higher aspergillosis spore counts contribute to higher 
rates of invasive disease among immunocompromised patients. However, 
there is not consensus about whether there should be a benchmark spore 
count or on the best methods to purify air.
    Outbreaks of child-care-associated illness may be caused by many 
different agents and involve several different modes of transmission. 
The environment can play an important role in these outbreaks. Most 
environmental studies in child care settings have focused on enteric 
diseases. Toys and surfaces become contaminated either directly or 
indirectly by feces and body secretions from ill children. The 
incidence of diarrhea has been associated with isolation of fecal 
coliforms from hands of children and staff and from various 
environmental surfaces in child-care centers. Levels of environmental 
fecal coliforms have also been linked with diaper type and the use of 
over clothing in classes of non-toilet-trained children in child-care 
centers. Cytomegalovirus has also been isolated from hands and toys in 
a classroom with a high prevalence of infected children. Although 
respiratory infections account for the majority of illness episodes 
among children in child-care facilities, relatively little work has 
been done on the environmental aspects of these infections.
    The relationship between results of environmental monitoring of 
microbial agents and the risk of infection from these agents in the 
environment remains largely undefined. In addressing this issue, it is 
necessary to consider the following requirements for environmental 
transmission of disease to take place: (1) presence of a microbial 
agent in the environment, (2) the organism must have sufficient 
virulence, (3) relatively high numbers of organisms, (4) mechanism of 
transmission from the environment to the host, (5) a successful portal 
of entry, and (6) a susceptible host.

Purpose

    The purpose of the EARP is to provide financial and technical 
assistance for applied research projects on emerging infections in the 
U.S. As a component of EARP, the purpose of this grant/cooperative 
agreement announcement is to provide assistance for one or more 
projects addressing the correlation of environmental monitoring of 
microbial agents with disease control. Environmental monitoring may 
play an important role in infectious disease control. However, 
additional studies are needed to correlate results of environmental 
monitoring with human disease. Examples of areas needing attention 
include, but are not limited to, Legionella and Cryptosporidia in 
water, Aspergillus spores in air, vancomycin-resistant enterococci and 
other agents in hospital and child-care environments. Where 
appropriate, projects proposed may include interventions to evaluate 
detection methods.

Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities under A. 
(Recipient Activities), and CDC will be responsible for conducting 
activities under B. (CDC Activities) under cooperative agreements:

A. Recipient Activities

    1. Identify a microbial agent of increasing public health 
importance that has a known environmental reservoir (air, water, etc).
    2. Conduct surveillance for human infections in a particular 
setting, e.g., child-care facilities, health-care facilities 
(hospitals, clinics, long-term care facilities), etc.
    3. Define the relationship between finding the target organism in 
the environment and the risk of human disease in the target setting.
    4. If feasible, determine the cost effectiveness of different 
options for microbial detection and disease control; determine 
interventions where appropriate.
    5. Publish and/or otherwise disseminate study findings.

B. CDC Activities (Cooperative Agreements)

    1. Provide technical assistance in the design and conduct of the 
research.
    2. Perform selected laboratory tests, as appropriate and necessary.
    3. Participate in data management, the analysis of research data, 
and the interpretation and presentation of research findings.
    4. Provide biological materials (e.g., strains, reagents, etc.) as 
necessary for studies.

Technical Reporting Requirements

    Narrative progress reports are required semiannually. The first 
semiannual report is required with the first noncompeting continuation 
application and should cover program activities from date of award. The 
second semiannual report is due 90 days after the end of each budget 
period and should cover activities from the date of previous report. 
Progress reports should summarize tasks completed, problems 
encountered, and plans for continued research activities. Reports 
should also include copies of any publications resulting from the 
project.
    An original and two copies of a Financial Status Report (FSR) are 
required not later than 90 days after the end of each budget period.
    A final performance report and FSR are due not later than 90 days 
after the end of the project period. All reports are to be submitted to 
the Grants Management Branch, CDC.

Application

1. Pre-application Letter-of-Intent

    In order to enable CDC to plan the review of applications submitted 
under this Program Announcement, all parties intending to submit 
application(s) are requested to inform CDC of their intention to do so 
as soon as possible but not later than 30 business days prior to the 
application due date. Notification should include: (1) this program 
announcement number (99005), (2) name and address of institution, and 
(3) name, address, and phone number of contact person. Notification can 
be provided by Facsimile, postal mail, or electronic mail (E-mail) to: 
Matthew Arduino, Dr. P.H., National Center for Infectious Diseases, 
Centers for Disease Control and Prevention (CDC) 1600

[[Page 36918]]

Clifton Road, NE., Mailstop C-1, Atlanta, GA 30333, Facsimile (404) 
639-3822, E-mail <a href="/cdn-cgi/l/email-protection#acc1c6cd98eccfc8cf82cbc3da"><span class="__cf_email__" data-cfemail="721f181346321116115c151d04">[email protected]</span></a>.

2. Application Content

    Applicants are strongly encouraged to develop applications in 
accordance with PHS Form 398 information contained in this grant/
cooperative agreement announcement, and the instructions outlined 
below.
    The original and five (5) complete copies of the application must 
be UNSTAPLED and UNBOUND. ALL pages must be clearly numbered, and a 
complete index to the application and its appendices must be included. 
All typewritten materials must be single-spaced, using a font no 
smaller than size 12. All supplemental pages of the application (i.e., 
in addition to the 398 forms) must be on the 8\1/2\'' by 11'' white 
paper. All pages must be printed on ONE side only, with at least 1'' 
margins, headers, and footers.
    The application narrative must not exceed 12 pages (excluding 
budget and appendices). Unless indicated otherwise, all information 
requested below must appear in the narrative. Materials or information 
that should be part of the narrative will not be accepted if placed in 
the appendices. The application narrative must contain the following 
sections in the order presented below:
a. Abstract
    Provide a brief (two pages maximum) abstract of the project. 
Clearly identify the project period proposed (not to exceed maximum of 
3 years as indicated in Availability of Funds Section). Clearly 
identify the type of award that is being applied for, grant or 
cooperative agreement.
b. Background and Need
    Discuss the background and need for the proposed project. 
Demonstrate a clear understanding of the purpose and objectives of this 
program announcement. Discuss and demonstrate how the proposed project 
addresses an important gap which is of public health importance.
c. Capacity and Personnel
    Describe applicant's past experience in conducting activities 
similar to that being proposed. Describe applicant's resources, 
facilities, and professional personnel that will be involved in 
conducting the project. Clearly identify specific assigned 
responsibilities for all key professional personnel. Include in an 
appendix curriculum vitae for all professional personnel involved with 
the project. Describe plans for administration of the project and 
identify administrative resources/ personnel that will be assigned to 
the project. Provide in an appendix letters of support from all key 
participating non-applicant organizations, individuals, etc. (if any), 
which clearly indicate their commitment to participate as described in 
the operational plan. (Do not include letters of support from CDC 
personnel--they will not be accepted.)
d. Objectives and Technical Approach
    Present specific objectives for the proposed project which are 
measurable and time-phased and are consistent with the Purpose and 
Program Requirements (Recipient Activities) sections of this 
announcement. Present a detailed operational plan for initiating and 
conducting the project which clearly and appropriately addresses these 
objectives (if proposing a multi-year project, provide a detailed 
description of first-year activities and a brief overview of 
subsequent-year activities). Include a clear description of applicant's 
technical approach/methods which are directly relevant to the above 
objectives. Describe specific study protocols or plans for the 
development of study protocols. Describe the nature and extent of 
collaboration with CDC (if proposing a cooperative agreement) and/or 
others during various phases of the project. Describe in detail a plan 
for evaluating progress toward achieving process and outcome project 
objectives. If the project will employ a particular research subject 
population, describe characteristics of the patient population and how 
research in this subject group will yield generalizable information. 
Describe contingency plans which acknowledge how the project will 
address likely obstacles and assure that the proposed task(s) can still 
be completed. Include sample size calculations where appropriate to 
assure that measurable objectives can be evaluated.
e. Budget
    Provide a line-item budget and accompanying detailed, line-by-line 
justification for the first year of the project that demonstrates the 
request is consistent with the purpose and objectives of this program. 
If requesting a multi-year project, provide estimated total budget 
(direct plus indirect) for subsequent years. If requesting funds for 
any contracts, provide the following information for each proposed 
contract: (1) Name of proposed contractor, (2) breakdown and 
justification for estimated costs, (3) description and scope of 
activities to be performed by contractor, (4) period of performance, 
and (5) method of contractor selection (e.g., sole-source or 
competitive solicitation).
f. Human Subjects
    Whether or not exempt from DHHS regulations, if the proposed 
project involves human subjects, describe in an appendix adequate 
procedures for the protection of human subjects. Also, ensure that 
women, racial and ethnic minority populations are appropriately 
represented in applications for research involving human subjects.

Evaluation Criteria

    Applications will be reviewed and evaluated according to the 
following criteria:

1. Background and Need (15 Points)

    Extent to which applicant demonstrates a clear understanding of the 
background, purpose, and objectives of the project and the extent to 
which the proposed project addresses an area of public health 
importance not adequately addressed in ongoing programs.

2. Capacity (30 Points)

    Extent to which applicant describes adequate resources and 
facilities (both technical and administrative) for conducting the 
project. Extent to which applicant documents that professional 
personnel involved in the project are qualified and have past 
experience and achievements in research related to that proposed as 
evidenced by curriculum vitae, publications, etc. Extent to which 
applicant clearly identifies specific assigned responsibilities of all 
key professional personnel. If applicable, extent to which applicant 
includes letters of support from non-applicant organizations, 
individuals, etc., and the extent to which such letters clearly 
indicate the author's commitment to participate as described in the 
operational plan.

3. Objectives and Technical Approach (55 Points Total)

    a. Extent to which applicant describes objectives of the proposed 
project which are consistent with the purpose of this announcement and 
which are measurable and time-phased. (15 points)
    b. Extent to which applicant presents a detailed operational plan 
for initiating and conducting the project which clearly and 
appropriately addresses all Recipient Activities. Extent to which the 
plan clearly describes applicant's technical approach/methods for 
conducting the proposed studies and extent to which the approach/
methods are appropriate and adequate to

[[Page 36919]]

accomplish the objectives. Extent to which applicant describes specific 
study protocols or plans for the development of study protocols that 
are appropriate for achieving project objectives. Extent to which 
applicant describes adequate and appropriate collaboration with CDC (if 
proposing a cooperative agreement) and/or others during various phases 
of the project. If the proposed project involves human subjects, 
whether or not exempt from the HHS regulations, the extent to which 
adequate procedures are described for the protection of human subjects, 
and the extent that women, racial and ethnic minority populations are 
appropriately represented in applications involving human research. (35 
points)
    c. Extent to which applicant provides a detailed and adequate plan 
for evaluating progress toward achieving project process and outcome 
objectives. (5 points)

4. Budget (Not Scored)

    Extent to which the proposed budget is reasonable, clearly 
justifiable, and consistent with the intended use of grant/cooperative 
agreement funds.

Executive Order 12372 Review

    This program is not subject to Executive Order 12372 Review.

Public Health System Reporting Requirements

    This program is not subject to the Public Health System Reporting 
Requirements.

Catalog of Federal Domestic Assistance Number

    The Catalog of Federal Domestic Assistance Number is 93.283.

Other Requirements

Paperwork Reduction Act

    Projects that involve the collection of information from ten or 
more individuals and funded by the grant/cooperative agreement will be 
subject to review by the Office of Management and Budget (OMB) under 
the Paperwork Reduction Act.

Human Subjects

    If the proposed project involves research on human subjects, the 
applicant must comply with the Department of Health and Human Services 
Regulations (45 CFR Part 46) regarding the protection of human 
subjects. Assurance must be provided to demonstrate that the project 
will be subject to initial and continuing review by an appropriate 
institutional review committee. The applicant will be responsible for 
providing evidence of this assurance in accordance with the appropriate 
guidelines and form provided in the application kit.
    In addition to other applicable committees, Indian Health Service 
(IHS) institutional review committees also must review the project if 
any component of IHS will be involved or will support the research. If 
the Native American community is involved, its tribal government must 
also approve that portion of the project applicable to it.

Women, Racial and Ethnic Minorities

    It is the policy of the CDC and the Agency for Toxic Substances and 
Disease Registry (ATSDR) to ensure that individuals of both sexes and 
the various racial and ethnic groups will be included in CDC/ATSDR-
supported research projects involving human subjects, whenever feasible 
and appropriate. Racial and ethnic groups are those defined in OMB 
Directive No. 15 and include American Indian or Alaska Native, Asian, 
Black or African American, Hispanic or Latino, Native Hawaiian or Other 
Pacific Islander. Applicants shall ensure that women, racial and ethnic 
minority populations are appropriately represented in applications for 
research involving human subjects. Where clear and compelling rationale 
exist that inclusion is inappropriate or not feasible, this situation 
must be explained as part of the application. This policy does not 
apply to research studies when the investigator cannot control the 
race, ethnicity, and/or sex of subjects. Further guidance to this 
policy is contained in the Federal Register, Vol. 60, No. 179, pages 
47947-47951, and dated Friday, September 15, 1995.

Animal Subjects

    If the proposed project involves research on animal subjects, the 
applicant must comply with the ``PHS Policy on Humane Care and Use of 
Laboratory Animals by Awardee Institutions.'' An applicant organization 
proposing to use vertebrate animals in PHS-supported activities must 
file an Animal Welfare Assurance with the Office for Protection from 
Research Risks at the National Institutes of Health.

Application Submission and Deadline

    The original and five complete copies of each application PHS Form 
398 must be submitted to Sharron P. Orum, Grants Management Officer, 
Grants Management Branch, Procurement and Grants Office, Centers for 
Disease Control and Prevention (CDC), 255 East Paces Ferry Road, NE., 
Room 300, Mailstop E-18, Atlanta, GA 30305, on or before October 1, 
1998.
    1. Deadline: Applications shall be considered as meeting the 
deadline if they are either:
    a. Received on or before the deadline date; or
    b. Sent on or before the deadline date and received in time for 
submission to the objective review group. (Applicants must request a 
legibly dated U.S. Postal Service postmark or obtain a legibly dated 
receipt from a commercial carrier or U.S. Postal Service. Private 
metered postmarks shall not be acceptable as proof of timely mailing.)
    2. Late Applications: Applications which do not meet the criteria 
in 1.a. or 1.b. above are considered late applications. Late 
applications will not be considered and will be returned to the 
applicant.

Where To Obtain Additional Information

    To receive additional written information and to request an 
application kit, call 1-888-GRANTS (1-888 472-6874). You will be asked 
to leave your name and address and will be instructed to identify the 
announcement number of interest. (Please refer to Announcement Number 
99005.) You will receive a complete program description, information on 
application procedures and application forms.
    If you have questions after reviewing the contents of all the 
documents, business management technical assistance may be obtained 
from Oppie M. Byrd, Grants Management Specialist, Grants Management 
Branch, Procurement and Grants Office, Centers for Disease Control and 
Prevention (CDC), 255 East Paces Ferry Road, NE., Room 314, Mailstop E-
18, Atlanta, GA 30305, telephone (404) 842-6546, Facsimile (404) 842-
6513, Internet <a href="/cdn-cgi/l/email-protection#4e21362c7d0e2d2a2d60292138"><span class="__cf_email__" data-cfemail="422d3a2071022126216c252d34">[email protected]</span></a>.
    Programmatic technical assistance may be obtained from Matthew J. 
Arduino, M.S., Dr.P.H., National Center for Infectious Diseases, 
Hospital Infections Program, Centers for Disease Control and Prevention 
(CDC), 1600 Clifton Road, NE., Mailstop C-01, Atlanta, GA 30333, 
telephone (404) 639-2318, Internet <a href="/cdn-cgi/l/email-protection#8be6e1eabfcbe8efe8a5ece4fd"><span class="__cf_email__" data-cfemail="b1dcdbd085f1d2d5d29fd6dec7">[email protected]</span></a>.
    You may obtain this announcement from one of two Internet sites on 
the actual publication date: CDC's homepage at http://www.cdc.gov or at 
the Government Printing Office homepage (including free on-line access 
to the Federal Register at http://www.access.gpo.gov).

[[Page 36920]]

    Potential applicants may obtain a copy of Healthy People 2000 (Full 
Report, Stock No. 017-001-00474-0) or Healthy People 2000 (Summary 
Report, Stock No. 017-001-00473-1) referenced in the Introduction 
through the Superintendent of Documents, Government Printing Office, 
Washington, D.C. 20402-9325, telephone: (202) 512-1800.

    Dated: July 1, 1998.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 98-18017 Filed 7-7-98; 8:45 am]
BILLING CODE 4163-18-P


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